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Tuesday, September 20, 2011

Scientists Confirm: A Moment on the Lips, Forever On the Hips

I read a story today that reminded me of a recent exchange with a Starbucks barista who,  in response to my order of a small cafe mocha, inquired brightly,

“Would you like whipped cream on that?”  She smiled conspiratorially. “It's only 10 calories!”
Sure, I said.  What, after all, is 10 calories?  

Well, according to obesity researcher Dr. Kevin D. Hall of the National Institute of Diabetes and Digestive and Kidney Diseases, the daily addition of those 10 calories with my coffee will raise the body weight of the average person by 20 pounds in 30 years
And just in case you are thinking that a calorie is a calorie is a calorie, these researchers (whose study, published in The Lancet, was also summarized in the New York Times article Why Even Resolute Dieters Fail) also found that  saying “yes” to the whipped cream will result in more pounds gained by a heavier person than by a lean one.  

Adding insult to injury, the heavier person will gain not only more weight but more ‘fat’ weight vs. ‘lean’ weight.   That’s right – not just more fat, but fatter fat. 
The two phased approached suggested by these researchers on how to achieve lasting weight loss might classify as the closest thing to  a scientifically proven way to lose it for good, so I reprint here:
Phase 1  implement a temporary, aggressive change in behavior
 Phase 2   segue to more relaxed but permanent behavioral changes that can prevent the weight regain

For some facing serious and long-term consequences of excess weigh (such as Type 2 Diabetes), a surgical procedure is the best way to implement Phase 1 - anything from the non-invasive 20-minute outpatient gastric banding (LAP-BAND) procedure, to the significantly more invasive RNY gastric bypass procedure featuring stomach resection (80% removed) and intestinal re-routing.  


Because the number of weight loss surgeries has increased so dramatically (more than 500,000 LAP-BANDS placed since 1993), the number and type of surgical options has expanded as well. One of the latest innovations of bariatric medicine offers patients more weight loss opportunity with less risk: the Green Zone Gastric Plication, an evolution of the surgery for GERD (reflux) that shows very promising weight loss results with less risk of early and acute complication.

10 Celebrities Who Have Had Weight Loss Surgery

For weight loss maintenance, research results from the National Weight Control Registry suggest two tactics:
-  continuing physical activity
-  regular weigh-ins

Why Diets Don't Work  According to the research, there is a good reason most people can’t stick to their diets; diets actually don’t work.  Let’s look at the numbers to prove it: if a pound is comprised of 3500 calories, then creating a caloric deficit of 3500 calories over 7 days (a 500 calorie reduction each day) should result in a weight loss of one pound per week.
Not so, according to Dr. Hall et al, who built a model for weight loss that demonstrates obese people actually have to cut more calories to lose weight than it took to gain the extra pounds in the first place. 
The research authors note that typical weight-loss programs result in significant losses over a period 6-8 months, at which point most dieters (more than 95%) reach a sort of universal plateau. Then, prompted by an internal set point -  most dieters begin, unconsciously, start to eat a little more - a couple of saltine crackers here, a banana there, half a cookie in between.  
Though an extra 100 daily calories would be undetectable on a day to day basis for most of us, the weight game, as most of us know, is all about time. 



Let’s Move  Though the claim that one’s physical activity does not have much, if any, effect on weight loss tends to hover around dieters like bees around  honey, Dr. Hall’s model suggests otherwise.
Turns out First Lady Michelle Let's Move anti-obesity initiative is aptly named.  According to Dr. Hall’s weight loss model calculations, physical activity is critical to weight loss and especially to weight maintenance.  

For example: A man weighing 220 pounds who runs an additional 12.5 miles a week at a moderate pace would lose more weight at a faster rate than if he cut calories alone.   

Low-Carb Mania   So all diets are equally bad? Not so fast, say the researchers, who conclude
"some diets can lead to reduced hunger, improved satiety, and better overall diet adherence”
Is Atkins one of them? Dr.  Hall et al are circumspect on this score.   Although there have been numerous studies indicating low-carb, high protein  diets are more effective for losing weight, the researchers say little is known about the long-term effect of such diets and how they compare to more balanced distributions of fat, protein and carbohydrate in terms of weight maintenance or health of the dieter. Stay tuned!
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